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Pacemaker-mediated angina.
1Department of Cardiology, University of South Alabama, Mobile, Alabama, USA.
Experimental and Clinical Cardiology
|December 3, 2013
Summary
Pacemaker-mediated angina, a rare complication, occurred in a patient with chest pain after dual-chamber pacemaker placement. Switching the pacemaker mode relieved the angina, highlighting the importance of thorough patient history.
Area of Science:
- Cardiology
- Medical Devices
- Clinical Case Reports
Background:
- Angina pectoris is chest discomfort caused by myocardial ischemia, often due to atherosclerotic coronary artery disease.
- Dual-chamber pacemakers are devices that coordinate atrial and ventricular electrical activity to maintain optimal heart rhythm.
- Pacemaker-mediated tachycardia (PMT) can occur, but pacemaker-mediated angina is an infrequently reported complication.
Observation:
- A 78-year-old male presented with chest pain shortly after the implantation of a permanent dual-chamber pacemaker.
- The patient experienced immediate relief from his chest pain upon reprogramming the pacemaker.
- The pacemaker was switched from tracking the atrium and pacing the ventricle to sensing and pacing the ventricle.
Findings:
- The patient's chest pain was diagnosed as angina pectoris, directly linked to the pacemaker's function.
- This represents the first reported case of angina mediated by a dual-chamber pacemaker in medical literature.
- The specific pacemaker mode triggered the ischemic pain, suggesting a novel mechanism of pacemaker-induced angina.
Implications:
- This case underscores the importance of considering pacemaker-mediated angina in patients experiencing chest pain post-implantation.
- Thorough pre-pacemaker placement evaluation, including patient history, is crucial for identifying potential risks.
- Reprogramming pacemaker settings can effectively manage and resolve pacemaker-mediated angina, offering a treatment strategy.
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